Online ISSN: 2515-8260

Author : Amirajam, Sara

Detection of SARS-CoV-2 in Follicular and Endocervical Fluid of IVF Candidates with Positive PCR Tests

Mina Ataei .; Ali Sadeghitabar; Atousa Karimi; Marjan Ghaemi; Sara Amirajam; Soheila Ansaripour

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 3752-3758

Introduction & Objective: The COVID-19 pandemic is a unique global challenge with a wide range of severity
extending from an asymptomatic form to a serious intense respiratory syndrome. We have restarted the ART
treatments in cases that need emergent IVF treatment according to the international and local guidelines. This
study aimed to evaluate the presence of viruses in follicular and endocervical fluid in patients with a positive
PCR tests provided on the day of the oocyte trigger. Method: All participants and their partners, who were a
candidate to start ART from April 2020 to October 2020, completed a triage questionnaire two weeks before
starting the ART cycle. A PCR test was performed for all participants before starting the cycle. According to
Avicenna center protocol, a diagnostic test (real-time PCR) by Dacron swap and Pishtazteb kit. The
nasopharynx test for COVID-19 was conducted for all ART patients 48 hours before the day of the oocyte
trigger. PCR test was positive in 32 women. In the operating theater, sterile swabs were used to provide
cervicovaginal specimens to determine COVID 19 virus in cervicovaginal fluid. Also, the first aspirated
follicular fluid was referred to the lab to assess the presence of COVID 19. Result: In this study, virus particles
were not detected in the follicular and endocervical fluid of the women with positive PCR tests. Case
presentation: We describe 32 patients who were candidates for IVF, with approved positive COVID-19 PCR
tests to evaluate whether the virus is present in the follicular and endocervical fluid or not? Discussion: We are
still at the beginning of the road and need reliable data on the safety of the ART at the time of pandemic. The
risk of infection during all process of ART including oocyte retrieval needs attention. The fluids from mature
follicles are a potential site to be infected and the human cumulus cells could not be a deterrent factor to
entrance of the virus in the oocyte. This process may lead to gametes infection. Indeed in real life evaluating
the risk of sexual transmission of COVID-19 is very important. Conclusion: We did not detect virus RNA in
the follicular and endocervical fluid of the patients with positive PCR test. Although, more studies with a
greater sample size are mandatory in this field.